Adherence to the ABC (Atrial fibrillation Better Care) pathway in the Balkan region: the BALKAN-AF survey

Kozieł, Monika; Simović, Stefan; Pavlović, Nikola; Kocijancic, Aleksander; Paparisto, Vilma; Musić, Ljilja; Trendafilova, Elina; Dan, A.; Kušljugić, Zumreta; Dan, Gheorghe‐Andrei; Lip, Gregory Y.H.; Potpara, Tatjana

doi:10.20452/pamw.15146

Cited by 16 publications

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“…After the titles and abstracts screening, 14 full texts were evaluated, and eight studies were included in the final systematic review and meta-analysis(16-23) (Table 1) [Figure S1], with a total of 285,253 AF patients included (23). Four studies were based in Europe (17,18,20,24), two in Asia (22,23), one in North America (19) and one was multinational (21).…”

Section: Resultsmentioning

confidence: 99%

“…Among the eight included studies, two were post-hoc subgroup analyses of previously performed RCTs (19,21), four were based on observational registries (16)(17)(18)20) while the last one was derived from a nationwide claims registry (22). One study did not include a follow-up phase (17). The only RCT, the 'mobile Atrial Fibrillation Application II' (mAFA-II), a cluster-randomized study conducted in China, implemented the ABC pathway through a mobile phone application.…”

Section: Resultsmentioning

confidence: 99%

“…17 The only RCT, the 'mobile Atrial Fibrillation Application II' (mAFA-II), a cluster-randomised study conducted in China, implemented the ABC pathway through a mobile phone application. Six out of eight studies [17][18][19][20][21]23 enrolled both out-and in-patients, while the remaining two only considered hospitalised patients. 16,22 Prevalence of ABC-Pathway-Adherent Care Among the seven observational studies included in the systematic review, we found a pooled prevalence of a clinical management adherent to the ABC pathway criteria equal to 21% (95% CI: 13-34%), with a high heterogeneity (I 2 ¼ 100%; ►Fig.…”

Section: Resultsmentioning

confidence: 99%

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Adherence to the ‘Atrial Fibrillation Better Care’ Pathway in Patients with Atrial Fibrillation: Impact on Clinical Outcomes—A Systematic Review and Meta-Analysis of 285,000 Patients

et al. 2021

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Aims: The ‘Atrial Fibrillation Better Care’ (ABC) pathway has been recently proposed as a holistic approach for the comprehensive management of patients with Atrial Fibrillation (AF). We performed a systematic review of current evidence for the use of the ABC pathway on clinical outcomes. Methods and Results: We performed a systematic review and meta-analysis according to PRISMA Guidelines. Pubmed and EMBASE were searched for studies reporting the prevalence of ABC pathway adherent management in AF patients, and its impact on clinical outcomes (all-cause death, cardiovascular death, stroke, and major bleeding). Metanalysis of odds ratio (OR) was performed with random-effect models; subgroup analysis and meta-regression were performed to account for heterogeneity. Among the 8 studies included, we found a pooled prevalence of ABC adherent management of 21% (95% confidence intervals (CI), 13-34%), with a high grade of heterogeneity, explained by the increasing adherence to each ABC criterion. Patients treated according to the ABC pathway showed a lower risk of all-cause death (OR:0.42, 95%CI 0.31-0.56), cardiovascular death (OR:0.37, 95%CI 0.23-0.58), stroke (OR:0.55, 95%CI 0.37-0.82) and major bleeding (OR:0.69, 95%CI 0.51-0.94), with moderate heterogeneity. Prevalence of comorbidities were moderators of heterogeneity for all-cause and cardiovascular death, while longer follow-up was associated with increased effectiveness for all outcomes. Conclusion: Adherence to the ABC pathway was suboptimal, being adopted in 1 in every 5 patients. Adherence to the ABC pathway was associated with a reduction in the risk of major adverse outcomes.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Adherence to the ‘Atrial Fibrillation Better Care’ Pathway in Patients with Atrial Fibrillation: Impact on Clinical Outcomes—A Systematic Review and Meta-Analysis of 285,000 Patients

et al. 2021

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“…The study did not include a control group on vitamin K antagonists and the sample size was limited, so it was underpowered to compare 3 different DOACs. However, concomitant LC is observed solely in 3.3% of AF patients [13]. In conclusion, reduced-dose DOACs are relatively safe and effective in cirrhotic patients with AF.…”

Section: Resultsmentioning

confidence: 80%

Direct oral anticoagulants in patients with atrial fibrillation and liver cirrhosis: a single-center experience

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“…Several studies 12–23 have examined the impact of adherence/non-adherence to the ABC pathway. This review summarizes the definitions used for the ABC criteria in different datasets and evaluates the impact of adherence/non-adherence on clinical outcomes.…”

Section: Introductionmentioning

confidence: 99%

The Atrial Fibrillation Better Care pathway for managing atrial fibrillation: a review

et al. 2021

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The 2020 European Society of Cardiology guidelines endorse the Atrial Fibrillation Better Care (ABC) pathway as a structured approach for the management of atrial fibrillation (AF), addressing three principal elements: ‘A’ – avoid stroke (with oral anticoagulation), ‘B’ – patient-focused better symptom management, and ‘C’ – cardiovascular and comorbidity risk factor reduction and management. This review summarizes the definitions used for the ABC criteria in different studies and the impact of adherence/non-adherence on clinical outcomes, from 12 studies on seven different cohorts. All studies consistently showed statistically significant reductions in the risk of stroke, myocardial infarction, and mortality among those with ABC pathway adherent treatment. The ABC pathway provides a simple decision-making framework to enable consistent equitable care from clinicians in primary and secondary/tertiary care. Further research examining the impact of ABC pathway implementation in prospective cohorts utilizing consistent inclusion criteria and definitions of ‘A’, ‘B’, and ‘C’ adherent care is warranted.

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Adherence to the ABC (Atrial fibrillation Better Care) pathway in the Balkan region: the BALKAN-AF survey

Abstract: INTRODUCTION The Atrial fibrillation Better Care (ABC) pathway for holistic management, introduced in 2017, provides a useful approach (A,

Cited by 16 publications

References 16 publications

Adherence to the ‘Atrial Fibrillation Better Care’ Pathway in Patients with Atrial Fibrillation: Impact on Clinical Outcomes—A Systematic Review and Meta-Analysis of 285,000 Patients

Adherence to the ‘Atrial Fibrillation Better Care’ Pathway in Patients with Atrial Fibrillation: Impact on Clinical Outcomes—A Systematic Review and Meta-Analysis of 285,000 Patients

Direct oral anticoagulants in patients with atrial fibrillation and liver cirrhosis: a single-center experience

The Atrial Fibrillation Better Care pathway for managing atrial fibrillation: a review

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